Hedner U, Nilsson I M, Isacson S
Br Med J. 1976 Sep 25;2(6038):729-31. doi: 10.1136/bmj.2.6038.729.
Forty-nine patients with decreased fibrinolytic activity in the vessel walls or a decreased release mechanism, or both, were treated with ethyloestrenol for three to 17 months. Forty-five of the patients had had recurrent, phlebographically verified, deep venous thrombosis (DVT) and four had arterial thrombosis. Ethyloestrenol 8 mg/day was given to 31 patients and 4 mg/day was given to 12. The remaining six patients had been treated with a combination of phenformin and ethloestrenol. The phenformin was withdrawn but they were kept on ethyloestrenol 8 mg/day. Another 15 patients with a normal fibrinolytic system--four with recurrent DVT and 11 with severe arteriosclerosis--were given ethyloestrenol 8 mg/day. The spontaneous fibrinolytic activity, local fibrinolytic activity during standardised venous occlusion of the arms, and fibrinolytic activity of the vessel walls increased significantly after treatment with ethyloestrenol 8 mg/day for three months. No further increase occurred after three months, and ethyloestrenol 4 mg/day had no effect. No values rose significantly in the patients with a normal fibrinolytic system. One patient suffered a recurrence within three months of treatment, before the fibrinolytic system became normal. In one patient the fibrinolytic defect reappeared after 10 months in spite of continued treatment. Two of the three women of fertile age developed irregular cycles and intermenstrual bleeding, which disappeared when the treatment was withdrawn. No other side effects were observed.
49例血管壁纤溶活性降低或释放机制受损或两者皆有的患者接受了炔雌醇治疗，疗程为3至17个月。其中45例患者经静脉造影证实有复发性深静脉血栓形成（DVT），4例有动脉血栓形成。31例患者给予炔雌醇8毫克/天，12例给予4毫克/天。其余6例患者曾接受苯乙双胍和炔雌醇联合治疗。停用苯乙双胍后，他们继续服用炔雌醇8毫克/天。另外15例纤溶系统正常的患者——4例有复发性DVT，11例有严重动脉硬化——给予炔雌醇8毫克/天。服用炔雌醇8毫克/天治疗3个月后，自发纤溶活性、标准手臂静脉闭塞期间的局部纤溶活性以及血管壁的纤溶活性均显著增加。3个月后未进一步增加，且炔雌醇4毫克/天无效果。纤溶系统正常的患者各项指标均未显著升高。1例患者在治疗3个月内，纤溶系统尚未恢复正常时复发。1例患者尽管持续治疗，但10个月后纤溶缺陷再次出现。3例育龄女性中有2例出现月经周期不规律和经间期出血，停药后消失。未观察到其他副作用。
